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Running head: PATHOPHARMACOLOGICAL FOUNDATIONSIN HEART FAILURE1Michelle C KilbournePathopharmacological Foundations for Advanced Nursing PracticeWestern Governors UniversityHeart FailureA.Heart Failure
PATHOPHARMACOLOGICAL FOUNDATIONS IN HEART FAILURE2Heart failure (HF) is a condition in which a problem with the structure or function of the heart impairs its ability to supply sufficient blood flow to meet the body's needs (Wright, 2010) Heart failure currently affects six million Americans, with an estimated 870,000 new cases annually (Pattison, 2019). It affects an estimated 26 million people across the globe (Aguanno & Samson, 2017). Heart failure develops for many reasons that can include a range of malfunctioning heart valves to a more serious complication from a myocardial infarction. The AHA classifies heart failure into four stages based on structural heart damage. Stages A and B require minimal medications. Stage C is broken into two categories; heart failure with a preserved ejection fraction (HFpEF, ejection fraction > 45%) and heart failure with reduced ejection fraction (HFrEF, ejection fraction < 45%). Patients fall into these categories based on their left ventricle’s ability to pump blood or relax and fill with blood. Stage D of the AHA classification requires additional interventions beyond medication. (Pattison, 2019).A1. Pathophysiology of the Disease ProcessHeart failure develops and progresses into a disease as the heart is unable to produce the output demand from an increased need for oxygen and blood to the rest of the body. The heart muscle must compensate for this decreased heart strength and in doing so the muscle fibers stretch so that the heart can produce a stronger contraction to pump more blood with each beat. As the muscle stretches, the heart becomes enlarged. As the muscle becomes weaker and the heart becomes bigger, the muscle stretches out and the amount pumped is less efficient and is pumped with less force. Over time the heart becomes so weak and the muscle fibers cannot stretch. Due to this damage the heart cannot squeeze the required amount out of the ventricles and into the body. As the body reacts to less blood flow, the body preserves the heart and brain as they are the most vital organs in the body. As it preserves the heart and brain, the body diverts
PATHOPHARMACOLOGICAL FOUNDATIONS IN HEART FAILURE3blood from the non-essential organs causing them to fail and shut down. After time, the muscles become so stretched and weak, that they are unable to contract with the same force which decreases cardiac output even more. The final progression leads to lack of perfusion to even the essential organs like the heart and brain. This leads to certain death.During the progression of heart failure, the heart tries to compensate for inefficient profusion to organs by increasing the heart rate. This response is the heart’s reaction to try and increase the amount of blood pumped through the body. As the heart compensates the heart